Provider Demographics
NPI:1831140839
Name:GHEORGHIU, IOANA (MD)
Entity Type:Individual
Prefix:DR
First Name:IOANA
Middle Name:
Last Name:GHEORGHIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SADDLEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21153-2033
Mailing Address - Country:US
Mailing Address - Phone:410-602-0412
Mailing Address - Fax:
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-5250
Practice Address - Fax:410-601-8868
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD47012207P00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM40406OtherSTATE DRUG LICENSE NUMBER
MDD47012OtherMARYLAND LICENSE NUMBER
MDD47012OtherMARYLAND LICENSE NUMBER
MDG11239Medicare UPIN
MDS580900MMedicare ID - Type Unspecified